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Rigid intramedullary nail fixation of traumatic femoral fractures in the skeletally immature
OBJECTIVE: To determine the rate of femoral head osteonecrosis, and other complications following rigid intramedullary (IM) nail fixation of traumatic diaphyseal femur fractures through the greater trochanter in the skeletally immature. DESIGN: Retrospective review, case series. SETTING: Level I aca...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Lippincott Williams & Wilkins
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8568442/ https://www.ncbi.nlm.nih.gov/pubmed/34746660 http://dx.doi.org/10.1097/OI9.0000000000000128 |
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author | Del Balso, Christopher Bartley, Debra Cashin, Megan Carey, Timothy Lawendy, Abdel Rahman |
author_facet | Del Balso, Christopher Bartley, Debra Cashin, Megan Carey, Timothy Lawendy, Abdel Rahman |
author_sort | Del Balso, Christopher |
collection | PubMed |
description | OBJECTIVE: To determine the rate of femoral head osteonecrosis, and other complications following rigid intramedullary (IM) nail fixation of traumatic diaphyseal femur fractures through the greater trochanter in the skeletally immature. DESIGN: Retrospective review, case series. SETTING: Level I academic trauma center. PATIENTS/PARTICIPANTS: One hundred forty-eight traumatic pediatric diaphyseal femur fractures in 145 patients treated with rigid IM nail fixation from November 1, 2004 to December 31, 2018. INTERVENTION: Rigid intramedullary nail fixation of traumatic diaphyseal femur fractures through a trochanteric start point in the skeletally immature. MAIN OUTCOME MEASUREMENT: Rate of osteonecrosis of the femoral head. RESULTS: Sixty-five fractures in 64 skeletally immature patients met inclusion criteria. Motor vehicle collisions were implicated in 32 fractures. Of the 65 fractures, 5 were open. All rigid IM nails were anterograde with a trochanteric start point. Mean radiographic follow-up was 27.4 ± 8.1 months. Twenty-two patients experienced postoperative pain and/or hardware irritation, with 24 patients (36.9%) undergoing reoperation for hardware removal. No occurrences of infection, malunion, nonunion, refracture, venous thromboembolism, fat embolism, significant leg length discrepancy, or femoral head osteonecrosis were documented. Two cases of heterotopic ossification were observed, 1 requiring surgical excision, yielding a complication rate of 3.1%. CONCLUSIONS: No cases of femoral head osteonecrosis were observed following treatment of 65 traumatic diaphyseal femur fractures with rigid IM nailing through the greater trochanter with a mean radiographic follow-up of 27 months. Rigid IM nail fixation with a trochanteric start point is both safe and efficacious for management of diaphyseal femur fractures in the skeletally immature. |
format | Online Article Text |
id | pubmed-8568442 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-85684422021-11-05 Rigid intramedullary nail fixation of traumatic femoral fractures in the skeletally immature Del Balso, Christopher Bartley, Debra Cashin, Megan Carey, Timothy Lawendy, Abdel Rahman OTA Int Clinical/Basic Science Research Article OBJECTIVE: To determine the rate of femoral head osteonecrosis, and other complications following rigid intramedullary (IM) nail fixation of traumatic diaphyseal femur fractures through the greater trochanter in the skeletally immature. DESIGN: Retrospective review, case series. SETTING: Level I academic trauma center. PATIENTS/PARTICIPANTS: One hundred forty-eight traumatic pediatric diaphyseal femur fractures in 145 patients treated with rigid IM nail fixation from November 1, 2004 to December 31, 2018. INTERVENTION: Rigid intramedullary nail fixation of traumatic diaphyseal femur fractures through a trochanteric start point in the skeletally immature. MAIN OUTCOME MEASUREMENT: Rate of osteonecrosis of the femoral head. RESULTS: Sixty-five fractures in 64 skeletally immature patients met inclusion criteria. Motor vehicle collisions were implicated in 32 fractures. Of the 65 fractures, 5 were open. All rigid IM nails were anterograde with a trochanteric start point. Mean radiographic follow-up was 27.4 ± 8.1 months. Twenty-two patients experienced postoperative pain and/or hardware irritation, with 24 patients (36.9%) undergoing reoperation for hardware removal. No occurrences of infection, malunion, nonunion, refracture, venous thromboembolism, fat embolism, significant leg length discrepancy, or femoral head osteonecrosis were documented. Two cases of heterotopic ossification were observed, 1 requiring surgical excision, yielding a complication rate of 3.1%. CONCLUSIONS: No cases of femoral head osteonecrosis were observed following treatment of 65 traumatic diaphyseal femur fractures with rigid IM nailing through the greater trochanter with a mean radiographic follow-up of 27 months. Rigid IM nail fixation with a trochanteric start point is both safe and efficacious for management of diaphyseal femur fractures in the skeletally immature. Lippincott Williams & Wilkins 2021-04-09 /pmc/articles/PMC8568442/ /pubmed/34746660 http://dx.doi.org/10.1097/OI9.0000000000000128 Text en Copyright © 2021 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Orthopaedic Trauma Association. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) |
spellingShingle | Clinical/Basic Science Research Article Del Balso, Christopher Bartley, Debra Cashin, Megan Carey, Timothy Lawendy, Abdel Rahman Rigid intramedullary nail fixation of traumatic femoral fractures in the skeletally immature |
title | Rigid intramedullary nail fixation of traumatic femoral fractures in the skeletally immature |
title_full | Rigid intramedullary nail fixation of traumatic femoral fractures in the skeletally immature |
title_fullStr | Rigid intramedullary nail fixation of traumatic femoral fractures in the skeletally immature |
title_full_unstemmed | Rigid intramedullary nail fixation of traumatic femoral fractures in the skeletally immature |
title_short | Rigid intramedullary nail fixation of traumatic femoral fractures in the skeletally immature |
title_sort | rigid intramedullary nail fixation of traumatic femoral fractures in the skeletally immature |
topic | Clinical/Basic Science Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8568442/ https://www.ncbi.nlm.nih.gov/pubmed/34746660 http://dx.doi.org/10.1097/OI9.0000000000000128 |
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